Oral Cancer: a hidden foe | Sunday Observer

Oral Cancer: a hidden foe

11 July, 2021

The sharp rise in Oral Cancer (OC) in Sri Lanka which is the cause for one of the highest mortality rates among cancers in the country with several new cases being detected daily islandwide, has prompted officials at the National Cancer Control Programme (NCCP) to warn  the public to refrain from the risk factors that drive this highly preventable cancer. 

Consultant in Community Dentistry, National Cancer Control Programme, Dr. Udaya Usgodaarachchi when asked by the Sunday Observer to spell out some of the commonest causes for oral cancer  and  symptoms to look out for in detecting  early symptoms as well as the present ranking it had: “In Sri Lanka, Oral Cancer (OC) is the commonest cancer among males (approximately 15 percent) and is placed within the top ten commonest cancer among women.

According to the latest statistics in 2019, around 2,700 new cases are detected in the country (six new cases per day). OC carries one of the highest mortality rates among cancers in Sri Lanka, causing 2-3 deaths per day. Unfortunately, about 60% of OC are detected at late stages, requiring extensive treatment procedures which lead to permanent disfigurement and functional impairments. “

He said the main risk factors for OC in Sri Lanka are the use of tobacco (as smokeless tobacco or smoking), use of areca-nut products and consumption of alcohol. Certain risk groups, such as estate workers, drivers, fishermen, gem miners, construction site workers, security guards and farmers have a higher risk of getting OC because of high indulgence in risk factors.  He added that in a majority of situations, OCs are preceded by precursor lesions known as Oral Potentially Malignant Disorders (OPMD). They manifest as:

  •  Painless white, red or white/red mixed patches that cannot be wiped away
  • Unexplainable growth inside the mouth of recent occurrence
  • Non-healing wound/ulcer inside the mouth that persists for more than two weeks
  • Burning sensation of mouth when taking spicy foods of recent occurrence
  • Restricted mouth opening that cannot be explained by other factors, such as trauma
  • Unusual whitish appearance instead of pinkish colour in lips and oral mucosa of recent occurrence

As the majority of these lesions are painless, they are identifiable only through visual examination. If OPMD’s are identified early and managed properly, by abstaining from risk factors, malignant transformation can be prevented.

In his message to eliminate this preventable cancer, he emphasised the responsibility lay with the public. “Don’t start using or  get addicted to tobacco and areca-nut related products. If you are indulging in risk habits, STOP immediately.

Undertake self-mouth examination at least once a month. Undergo clinical oral examination by a dental surgeon at least once a year. Lastly, if you suspect that there is a lesion, do not hesitate to meet your dental surgeon for a check-up. If a lesion is identified, strictly adhere to treatment procedures and follow-ups.”

Recycling plastics a good solution: benefits human health

The Minister of Environment has instructed manufacturing companies and the CEA to propose an alternative program for the recycling of 750ml plastic bottles.  Under the program, the Ministry of Environment has banned several plastic and polythene related products. According to the Minister of Environment, plastics were being used because they were the only materials that were being manufactured despite eco-friendly easily perishable alternatives to them. However, though no permanent decision was made yet, the Minister said the permanent solution is the recycling program. 

Is this a step in the right direction? Is it practical? 

When Medi Snippets columnist asked forensic and toxicology expert Professor Ravindra Fernando, who has spearheaded the demand for alternative solutions to reduce plastic toxicity in the island, he said,  Yes, recycling program is a good solution.  Plastic waste is a key concern for environmentalists, governments and organisations, as vast majorities of plastics are disposed of in non-environmentally friendly ways, resulting in polluted oceans, overextended landfills and ecological damage. Thus, plastic recycling is critical to improving the environment and bettering waste management solutions. 

He said that recycling any material, where possible, is fundamental to the environment, however recycling plastic has specific benefits. Recycling plastic can conserve limited natural resources and energy; as plastic is made from oil, the more plastic that is recycled and the less that is made from raw materials, the more oil is conserved. 

“Unfortunately, plastic does not suit all eco-friendly disposal solutions. For example, not all plastic is widely recyclable and energy from incineration is not possible as burning plastics releases harmful gases. The difference in the recyclability of plastic types can be down to how they are made; thermoset plastics contain polymers that form irreversible chemical bonds and cannot be recycled, whereas thermoplastics can be re-melted and re-molded,” he said.

 Dengue down but doctors warn of rise in next two months

While dengue figures have plunged compared to the previous year and have dwindled steadily since January this year, doctors have warned of a possible spike in the next two months. This is due to the monsoon onset followed by short bursts of sunshine. Director of the National Dengue Control Unit of the Ministry of Health Dr. Aruna Jayasekara was recently quoted by the media as saying that people should take action to keep their surroundings clean as the risk of dengue is increasing during the months of June and July due to rainy weather.Since Dengue is also spreading in the midst of the coronavirus epidemic and show common symptoms, Medi snips asked a health official what action the public should take especially patients with diabetes, hypertension, cholesterol and other underlying diseases which lowered their immunity.

Speaking on grounds of anonymity he said that the public have been advised to see a doctor to diagnose the disease if symptoms occur without delay. “Go to the nearest hospital or health facility and get yourself checked,” the official said, adding that it is very important to seek medical attention in the event of fever and to do relevant laboratory investigations at least by day three of the illness. Health experts also advised parents whose children were sick or had fever to keep them home and monitor their temperature. Working persons have also been asked to stay away from work to prevent infecting others The total number of Dengue cases for last year( 2020) was 31,168.   

In June the numbers had totalled 2,252 compared to 995 cases this June (2021). Approximately 32.7 % of dengue cases were reported from the Western Province according to the latest report of the Epidemiology Unit. This year too Colombo district had the highest number of cases although the numbers were down considerably. Health officials said that on going spraying, fogging, dredging of canals and locating  unidentified neglected overgrown gardens, along with stiff penalties to offenders were some of the ongoing activities being taken.  They said schools, religious premises and construction sites had shown the highest percentage of breeding grounds for the dengue larvae. “We need the cooperation of the public to help us eliminate dengue,” National Dengue Unit sources were quoted as saying. 

Compiled by Carol Aloysius